Cancer Genetics and Epigenetics 2024, Vol.12, No.1, 15-26 http://www.medscipublisher.com/index.php/cge 21 CAR-T cell therapy also shows promise in treating recurrent endometrial cancer. Patients with recurrent endometrial cancer often have low tolerance to traditional treatment methods, whereas CAR-T cell therapy, by modifying a patient's own T cells, enhances their ability to attack tumor cells, effectively controlling disease progression. Furthermore, due to the personalized nature of CAR-T cell therapy, the most suitable CAR design can be selected based on the tumor characteristics of patients with recurrent endometrial cancer, thereby improving treatment specificity and effectiveness. Despite the potential benefits, CAR-T cell therapy in endometrial cancer treatment faces challenges. The heterogeneity of endometrial cancer poses a challenge in selecting appropriate specific antigens. Thus, finding more specific and widely expressed antigens will be a crucial research direction for CAR-T cell therapy in endometrial cancer treatment. Safety concerns surrounding CAR-T cell therapy in endometrial cancer treatment also require further research and resolution. CAR-T cell therapy may lead to serious adverse reactions like cytokine release syndrome and neurotoxicity, necessitating close monitoring and management. Despite facing challenges, the prospects of CAR-T cell therapy in the treatment of endometrial cancer are still promising. With the in-depth research and continuous improvement of CAR-T cell therapy technology, it is expected that CAR-T cell therapy will be widely used in the treatment of endometrial cancer (Loukovaara et al., 2022; Yang et al., 2023). 3 Clinical Application and Efficacy Evaluation of Immunotherapy 3.1 Application of immunotherapy in first-line treatment of endometrial cancer Immunotherapy, as a novel treatment approach, holds vast potential in the first-line treatment of endometrial cancer. First-line treatment refers to the therapy administered upon the initial diagnosis of endometrial cancer, aimed at improving patient survival rates and treatment outcomes. Currently, immunotherapy's application in the first-line treatment of endometrial cancer primarily involves immune checkpoint inhibitors and vaccine therapy. Immune checkpoint inhibitors work by suppressing inhibitory signaling molecules on the surface of tumor cells, activating the body's immune system to attack and eliminate tumor cells. Vaccine therapy, on the other hand, introduces tumor-related antigens to stimulate the body's immune response to suppress tumor growth. Studies indicate that immune checkpoint inhibitors have shown significant efficacy in the first-line treatment among certain endometrial cancer patients. For instance, the PD-1 inhibitor Pembrolizumab has been confirmed to significantly prolong progression-free survival and improve overall survival in first-line treatment. Additionally, some vaccine therapies have demonstrated certain therapeutic potential, such as cell-based vaccines and gene-engineered vaccines. As a first-line treatment option, epidemic treatment has certain advantages. Immunotherapy has lower toxicity compared to traditional chemotherapy and radiation therapy, potentially enhancing patients' quality of life. By activating the body's immune system, immunotherapy aims to boost patients' immune responses, potentially fostering anti-tumor immune effects, overcoming tumor resistance, and improving treatment durability (Zhang and Mao, 2023). It should be pointed out that the application of immunotherapy in the first-line treatment of endometrial cancer is still in the exploratory stage. Currently, there's a lack of sufficient clinical trial data to fully support its precise efficacy in first-line treatment. Additionally, individual differences and the response rates to immunotherapy are factors that need consideration. Therefore, clinical practitioners need to assess the pros and cons of treatment regimens and tailor personalized treatment plans based on each patient's specific circumstances. In conclusion, immunotherapy holds potential application prospects in the first-line treatment of endometrial cancer. As further research and clinical practice advance, gaining a more comprehensive understanding of the efficacy of immunotherapy in first-line treatment aims to offer more effective treatment options for patients (Figure 3). 3.2 Application of immunotherapy in recurrent or metastatic endometrial cancer Recurrent or metastatic endometrial cancer refers to the reoccurrence or spread of the primary lesion after surgical treatment or its extension to other sites. Conventional treatment methods often show limited effectiveness in such
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